Ethical Dilemmas in Caring for Yourself: The Inalienable Right to Get the Flu

It’s that time again—time to get lots of rest, drink lots of water, and obsessively wash your hands. It’s time to avoid the flu.

For many, a big part of the flu evasion ritual includes getting vaccinated. And with the season ramping up to be one of the worst in more than a decade, that might seem like a good idea. However, some would disagree, and that has led to an ongoing debate about the social responsibility of vaccination.

“Protecting oneself is an altruistic act,” Dr. Elizabeth Baorto told the Mother Nature Network. “By getting vaccinated, you not only protect yourself, but you protect those around you as well. We are fortunate that we have a cheap and effective way of protecting ourselves with the flu vaccine.”

Even when price isn’t a sticking point, there are many reasons people choose not to get the flu vaccine—allergies, religious beliefs, disappointment in effectiveness rates. Does that make them reckless misanthropes or should we all have a right to unvaccinated exposure?

For most people, the answer is simple. But for years now healthcare workers have faced sanctions or even termination if they opt out of the shot.

“Where does it say that I am no longer a patient if I'm a nurse,” Carrie Calhoun, a longtime Chicago critical care nurse asked in an NPR interview. Calhoun was fired for refusing to take a flu shot, according to NPR.

Although many would balk at the idea of an employer making health care choices for them, it’s different when your choice not to be treated can lead to someone becoming seriously ill or dying, say supporters of the stipulation.

“If you don't want to do it, you shouldn't work in that environment,” Art Caplan, medical ethics chief at New York University's Langone Medical Center, told NPR. “Patients should demand that their health care provider gets flu shots—and they should ask them.”

Caplan’s take-it-or-leave-it stance may apply in the healthcare world, but there are other callings that might also demand flu shots—such as motherhood. Research released last week indicated that while the flu shot is safe for pregnant women, actually contracting the flu could nearly double the chances of stillbirth or miscarriage.

“One misconception women have is that it’s no big deal—it’s just the flu,” researcher Camilla Stoltenberg of the Norwegian Institute of Public Health told Science News. “But it can be a big deal.”

Sometimes it’s the vaccine and not the flu that ruins your life. That’s the experience of about 800 European children who developed narcolepsy linked to a 2009 swine flu vaccination, according to Reuters. Scientists are investigating how the drug—which was given to 30 million people in 47 countries, although not in the United States—might be related to the debilitating condition.

“The big question is was it worth it? And retrospectively I have to say it was not,” Swedish public health official Goran Stiernstedt told Reuters. “This is a medical tragedy,” he said. "Hundreds of young people have had their lives almost destroyed."

“In the event of a severe pandemic, the risk of death is far higher than the risk of narcolepsy,” David Salisbury, the British government's director of immunization, told Reuters. “If we spent longer developing and testing the vaccine on very large numbers of people and waited to see whether any of them developed narcolepsy, much of the population might be dead.”

Given the unsure results of flu vaccine—both in effectiveness and long-term effects—it’s likely the to-vaccinate or not-to-vaccinate debate will continue until a better vaccine comes along. Until then, the flu will remain nothing to sneeze at.

Disaster News Redux: XL Pipeline Planning Back in the Flow

Clog in the Line: Planning for the mammoth Keystone XL Pipeline slowed to a trickle in November when the U.S. State Department announced it would halt permitting on the hotly contested project in order to assess possible environmental and health impacts of the 1,700-mile pipeline.

Environmentalists and landowners also celebrated news that the pipeline route—originally slated to stretch from Alberta, Canada, to refineries in Texas—would be altered to avoid Nebraska’s Ogallala Aquifer and the wetlands of the Sand Hills.

Although some heralded the double whammy as the beginning of the end for the project, others were less sanguine when pipeline proposer TransCanada immediately began talks with the Nebraska legislature to determine new routes the pipeline might take through the state. A poll of “energy insiders” by the National Journal indicated a majority thought the project would eventually move forward.

Newly Opened Channels: Nebraska governor Gov. Dave Heineman said that he approved a change in the pipeline route that would skirt the Sand Hills region and other “fragile soils,” according to a letter he wrote to President Obama.

The letter cites economic benefits and “minimal environmental impacts” as reasons for Nebraska’s about-face on the topic. The state was also heartened by TransCanada's assurances that it would take sole responsibility for any spills.

Environmentalists, however, weren’t comforted by the reroute, saying that even if there are no spills (one expert estimates there could be more than 91 spills in 50 years), U.S. reliance on the tar sands oil carried by the pipeline will be just as damaging.

“The latest pipeline review still ignores the biggest impact of Keystone XL: climate change,” May Boeve, the executive director of 350.org, told the New York Times. “The tar sands oil that would flow through Keystone XL is the dirtiest form of fuel on the planet, and burning it would have a devastating effect on our climate.”

Coming Down the Pipe: Much has been made of the awkward position Nebraska’s approval creates for President Obama after he touted the need to tackle human-caused climate change in his recent inaugural address. If the pipeline is allowed to go through, his commitment to climate change will be questioned. If it’s not, he’ll be seen as thwarting much needed economic growth—a drum that’s already being pounded.

“Nebraska’s approval of a new Keystone XL pipeline route means there is no bureaucratic excuse, hurdle, or catch President Obama can use to delay this project any further,” House Speaker John Boehner is quoted as saying in the Christian Science Monitor. “He and he alone stands in the way of tens of thousands of new jobs and energy security.”

Ultimately, the decision on how to proceed will be informed by the State Department’s National Interest Determination process. The department estimated in November that its review would be completed by March.

The Latest Natural Hazards Observer Is Online (and in Print!)

The latest edition of the Natural Hazards Observer is now available online. Featured articles from the January 2013 Observer include:

Hurricane Sandy Makes an Entrance

Turning Up the Heat on Climate Change

Overcoming Barriers to Disaster Risk Reduction

What Do We Really Learn from Experience?

And don’t forget, for those of you that would rather get the print edition, we’re now able to offer readers an Observer subscription for only $15 per year. Those interested in subscribing can sign up on our subscription page using a credit card, or be invoiced later.

Not so long ago (in our last issue, in fact), we were lauding the incredible growth DR has seen in its last 100 issues. This week we must say goodbye to someone who played a large role in making that happen.

It’s with sadness that we bid farewell to our Assistant Director for Programs and Outreach Ezekiel Peters. While many might know Zeke best for his forward-thinking partnerships and tireless promotion of the Center's offerings, he is probably less known for the deft and careful editing that has shaped both DR and the Natural Hazards Observer over the last five years.

It won’t be easy to soldier on after February 1 when Zeke leaves the Center to pursue his interests in emergency medical services and resilience, but we’re glad to see his formidable energy and problem-solving skills will still be working towards solutions for the hazards community. Good luck, Zeke. You’ll be missed.

Call Outs: Calls for Papers, Abstracts, Proposals, and More

Call for Abstracts2013 AFAC and Bushfire CRC ConferenceAustralasian Fire and Emergency Service Authorities Council Deadline: Feb. 15, 2013
The Australasian Fire and Emergency Service Authorities Council is now accepting abstracts for presentation at its 2013 AFAC and Bushfire CRC Conference to be held September 2-5 in Melbourne, Australia. Abstracts should be between 250 and 300
words and address conference themes, which include the need for transformational change, future emergency management challenges, large-scale disasters, and risk management. For more information and to submit your abstract online, see the conference Web site.

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Call for EntriesDam Safety 2013 Student Paper and Poster CompetitionsAssociation of State Dam Safety OfficialsDeadline: February 20, 2013The Association of State Dam Safety Officials is accepting entries for its annual student paper and poster competition. Students enrolled in North American institutions should submit a 350-word abstract and a 1,200-word executive summary of their work on any aspect of dam and levee safety. Winning entries will be presented at 30th Annual National Conference of State Dam Safety Officials to be held September 8-12 in Providence, Rhode Island, and could receive prizes of up to $500. For more information, visit the ASDSO Web site.

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Call for ParticipationSuper Storm Sandy: Relief Operations SurveyNational Disaster Interfaiths NetworkDeadline: Not Posted
The National Disaster Interfaiths Network is asking faith-based, nonprofit, and volunteer organizations to share information on relief services provided during and after Hurricane Sandy. Information such as the amount of volunteer and staff time, financial resources invested, clients served, and partnerships formed will be used to help quantify nongovernmental contributions and build networks for future use. For more information or to take the survey, visit the survey Web site.

Some New Web Resources

Tox Town and Tox Mystery
Like it or not, we live in a toxic world. The more we know about the danger, however, the better we can avoid it. These games from the National Library of Medicine help teach children in grades 2-12 what chemical or environmental dangers might be lurking in their home or neighborhood. The age-appropriate lessons will get them started, and there’s an abundance of resources for parents, teachers, and older students who want to further the lesson.

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Extreme Weather Map 2012
If you’re having a hard time visualizing just how extreme 2012's weather was, this interactive map from the Natural Resources Defense Council will do the trick. Visitors can view the record-breaking drought, high temperatures, and large-scale fires by month for the entire country or by state. And for those of you that aren’t wowed by nifty graphics, the site has a host of resources on the year’s extreme weather events and the mapping methodology.

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Capturing the Range of Learning: Implications for Disaster Health in a Resource Constrained Environment
Like many resource-strapped professions, healthcare professionals have been increasingly hard pressed to obtain the disaster-related education necessary to respond to emergencies. A little strategic thinking about how to deliver lessons might go a long way towards getting them the training they need. This paper, published by the National Center for Disaster Medicine and Public Health, finds that by using informal ways to deliver information, healthcare workers can be knowledgeable during disasters, even on a shoestring.

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Florida Catastrophic Storm Risk Management Center
It just got a little easier to dig through the trove of storm information collected by the Florida Catastrophic Storm Risk Management Center. The center’s recently updated Storm Risk Web site got more than a facelift—it now includes interactive timelines for catastrophic storm impact, global storm risk resources, and better tools for researching risk. Of course you’ll still find all the same great info on global, U.S., and Florida storm risk, you’ll just find it more easily.

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Maritime Security Outlook
The seafaring sort may have had a hard time finding their Internet niche in the past— especially when they specialize in security—but no longer. Maritime Security Outlook was conceived as a way for maritime professionals to share information, opinions, and resources, as well as find industry services and technical advice. Created by the folks behind Homeland Security Outlook, this new targeted site includes invited and aggregated editorials, news, events, and training programs.

February 11-13, 2013International LIDAR Mapping ForumAmerican Society for Photogrammetry and Remote Sensing Denver, ColoradoCost and Registration: $630 before February 11, open until filled
This conference will examine data capture technologies with an emphasis on mobile mapping systems. Topics include wetland mapping, scanning of roads and tunnels, terrain modeling, using mobile LIDAR to inventory transportation assets, and conservation planning with the U.S. Department of Agriculture’s National Elevation Program.

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February 12-15, 2013Building Resilient Communities through Policy and MitigationEarthquake Engineering Research InstituteSeattle, WashingtonCost and Registration: $650, open until filled
This conference will discuss earthquake policy and mitigation strategies that increase community resilience. Topics include the role of policy and mitigation in promoting resilient construction, seismic safety in schools, advances in tsunami-resistant structures, recovery modeling methodologies, post-earthquake assessment technology, and resilience models from across the country.

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February 18-22, 2013Fourth Fire Behavior and Fuels ConferenceInternational Association of Wildland FireRaleigh, North CarolinaCost and Registration: $530, open until filled
This conference will look at the future of wildland fire management and ways to best respond to population growth, climate change, and technology. Topics include water management for prescribed fires, controlled burn debates, future costs of wildfire suppression, best practices in risk and crisis communication, and LIDAR fuel measurements.

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March 5-7, 2013Missouri Community Forestry Council 20th Annual ConferenceMissouri Community Forestry CouncilJoplin, MissouriCost and Registration: $164, open until filled
This conference will discuss the effects of natural disasters on community forests and basic preparedness, mitigation, and disaster response strategies. Topics include the wildland urban interface, utility disaster response strategies, Joplin’s tornado recovery, flooding effects on trees along the Missouri River, and ways to leverage resources to restore trees after a disaster.

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March 19-21, 2013Natural Resource Distribution and Development in the 21st CenturyThe Society for Applied AnthropologyDenver, ColoradoCost and Registration: $150, open until filled
This conference examines how equitable access to basic resources can be sustained. Topics include issues of water usage and distribution, the impact of disasters on cultures and livelihoods, current drought adaptations and how they apply to future climate variability, coastal community disaster resilience strategies, postdisaster community reconstruction and resettlement, and the gaps between disaster knowledge, policy, and practice.

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March 20-22, 2013Disaster Resistant University WorkshopThe University of New Orleans CHARTNew Orleans, LouisianaCost and Registration: $30, open until filled
This conference will address the risk assessment and mitigation planning challenges facing universities. Topics include an introduction to multi-hazard mitigation planning, campus emergency management, the differences between disaster “resistance” and “resilience,” faculty’s role in building campus resilience, and how to conduct detailed vulnerability assessments of campus buildings.

Jobs, Jobs, Jobs

Global Systems Division Director
National Oceanic and Atmospheric AdministrationBoulder, ColoradoSalary: $119,554 to $179,700Closing Date: February 14, 2013
This position directs the Global Systems Division of NOAA’s Earth System Research Laboratory. Responsibilities include coordinating scientific programs, exploring new lines of research, appraising mission progress, improving data integration and forecasting technology, and providing scientific and technical direction to global weather and climate programs. A degree in physical science, mathematics, or engineering and the ability to effect strategic change and build external and internal partnerships are required.

--------------------Emergency Management CoordinatorCity of Miami BeachMiami Beach, FloridaSalary: $76,773 to $123,989Closing Date: February 15, 2013
This position will develop comprehensive disaster plans and programs. Responsibilities include managing the Community Emergency Response Team program, implementing disaster preparedness exercises, and assisting with evacuation, shelter, and catastrophic plans. A bachelor’s degree in emergency management, planning, or public administration and at least two years of experience in emergency management are required. Certification as a Florida Emergency Management Professional is preferred.

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Natural Hazards, Climate Change, and Resilience Postdoctoral FellowWharton Risk Management and Decision Processes CenterPhiladelphia, PennsylvaniaSalary: Not postedClosing Date: April 11, 2013
This position will examine decision making, risk management, and insurance as applied to natural hazards and climate change and work with the center directors and other researchers on projects in these areas. Original research is also expected. A strong background in analytics and a PhD in behavioral science, environmental science, economics, insurance, psychology, or sociology are preferred.

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Geospatial Analyst/DeveloperJudge GroupProvidence, Rhode IslandSalary: Not postedClosing Date: Open until filled
This position will support natural hazards research by obtaining, processing, and analyzing vector and raster datasets, georeferencing maps and aerial photographs, digitizing and preparing input data for natural hazard models, and creating hazard maps. A bachelor’s degree in GIS, civil engineering, or urban planning and experience with ArcGIS software are required.

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Emergency Response Program ManagerUS AirwaysPhoenix, ArizonaSalary: Not postedClosing Date: Open until filled
This position will develop training procedures to support US Airways’ corporate emergency response plan. Responsibilities include ensuring training is in compliance with federal regulations, managing emergency deployments, recruiting and screening volunteers, developing accident management procedures, and writing reports and newsletters. An undergraduate degree and at least four years of experience developing emergency response training programs are required.

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Catastrophe ModelerRisk Management SolutionsNewark, CaliforniaSalary: Not postedClosing Date: Open until filled
This position will build catastrophe models that quantify and manage earthquake risk. Responsibilities include developing earthquake vulnerability functions for computer-based risk models, developing vulnerability models for business interruptions, researching design and construction practices in various world regions, and preparing presentations and reports for internal and external publications. A master’s degree in civil engineering or mathematical modeling is required. At least two years of experience developing probabilistic risk models, advanced knowledge of probability and statistics, and a working knowledge of GIS software are preferred.